KLE SOCIETY’S
SCHOOL
1
(A Unit of KLE SOCIETY )
Affiliated to the Central Board of Secondary Education, New Delhi
Affiliation Number: 830113
II Block ,Rajajinagar,Bengaluru-10,
Ph no:080 23429807, Fax : 080 23429807
Website: www.klesiblr10.org
REGISTRATION FORM – CLASS XI
Regn. No:
Admn. No.:
1 . Name of the Applicant :
2. Residential Address:
3.Date of Birth:
4. Father’s Name :
Occupation :
(Designation and office
address)
5. Mother’s Name :
Occupation :
(Designation and office
address)
6. Contact Phone Number(s):
7. E- Mail Address:
Photo
For Office Use Only
2
8. Sex:
Male
9. a)Nationality :
a)
b)Religion:
b)
c)Category: OC/ SC/ ST/
BC/ MBC/ Others:
c)
Female
10. a. Name of the School where
candidate is studying Class
X at present:
b. Whether recognized
Yes
c. Board of Affiliation
CBSE
Matric
d. Medium of Instruction
English
others
11. Academic Performance :Std. X
I term Exam /SA 1
(Copy of the Report card to be
enclosed)
No
Sl.No. Subjects
1
English
2.
Maths
3.
Science
4.
Social Science
5.
II Language
12. Choice of Courses: English Compulsory
1. Physics, Chemistry, Mathematics, Biology
2. Physics, Chemistry, Mathematics, Computer Science
3. Physics, Chemistry, Mathematics,Economics
4. Economics, Business Studies, Accountancy, Computer Science
5. Economics, Business Studies, Accountancy, Mathematics
6. Economics, Business Studies, Accountancy, Entrepreneurship
7. Economics, Business Studies, Accountancy, Psychology
State
Others
% Marks /Grade
13. Certificate by Candidate & Father/Guardian:
I hereby certify that the information given above is true to the best of my knowledge and
belief. In case any of the information given above is found incorrect, I will abide by the
decision of the Principal.
Signature of Father/Guardian
(With date)
Signature of the candidate
(With date)
Note:
♦ Submission of Form does not guarantee Final admission.
♦ Entrance test marks are a pre requisite for admission.
♦ The School’s decision on admission is final.
FOR OFFICE USE ONLY
Reg: No. : ________________________________
Fees : ___________________________________
Date of registration
:_____________________________________
Date of Admission
:_____________________________________
Roll No. (at admission) :_____________________________________
Date :
Signature of Principal